Speaker request form Thank you for your interest in engaging a TPB speaker for your upcoming event. For consideration, please complete and submit this form. Contact details Question Title * Organisation Question Title * Contact name Question Title * Position Question Title * Phone Question Title * Email Question Title * Website Question Title * Alternate contact Question Title * Phone Event details Question Title * Event title Question Title * Date Question Title * Time Question Title * Location Question Title * Purpose and theme of event Question Title * Other speakers or topics being covered Session details Question Title * Topic Code of Professional Conduct Compliance matters Registration requirements Other (please specify) Question Title * Key messages Question Title * Expected outcomes Question Title * Scheduled speaking time Question Title * Length of presentation Question Title * Session format (panel, speech, Q&A) Question Title * Will session feedback be provided to the TPB? Yes No Audience Question Title * Type of audience Tax agents BAS agents Tax (financial) advisers Other (please specify) Question Title * Expected number of attendees Tax agents BAS agents Tax (financial) advisers Others Question Title * Level of experience Potential tax practitioner Newly registered practitioner Experienced tax practitioner Other (please specify) Question Title * Have you held this event before? Yes No Event requirements Please note, audio-visual equipment must be provided by the event organiser. Question Title * Materials required PowerPoint presentation Speaker Bio Speaker photo Case study Other (please specify) Question Title * Date material required Question Title * Will this event be recorded? Yes No Question Title * Please provide further information (directions, arrival time, parking arrangements, etc) The Tax Practitioners Board (TPB) uses SurveyMonkey to collect information. The information collected in this form is transmitted and stored securely in the United States and is accessed by the TPB in accordance with SurveyMonkey’s terms of use. You may decline to provide this information by not responding to this form. If you do complete the form you consent to storage of your information offshore (outside of Australia). This means that once you have chosen to complete the form, the TPB will not have an obligation to take reasonable steps to ensure that SurveyMonkey does not breach the Australian Privacy Principles in relation to personal information that is given to SurveyMonkey. View SurveyMonkey’s privacy policy Next
